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Vergara-Hernandez FB, Nielsen BD, Popovich JM, Panek CL, Logan AA, Robison CI, Ehrhardt RA, Johnson TN, Chargo NJ, Welsh TH, Bradbery AN, Leatherwood JL, Colbath AC. Clodronate disodium does not produce measurable effects on bone metabolism in an exercising, juvenile, large animal model. PLoS One 2024; 19:e0300360. [PMID: 38626145 PMCID: PMC11020481 DOI: 10.1371/journal.pone.0300360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/23/2024] [Indexed: 04/18/2024] Open
Abstract
Bisphosphonates are commonly used to treat and prevent bone loss, but their effects in active, juvenile populations are unknown. This study examined the effects of intramuscular clodronate disodium (CLO) on bone turnover, serum bone biomarkers (SBB), bone mineral density (BMD), bone microstructure, biomechanical testing (BT), and cartilage glycosaminoglycan content (GAG) over 165 days. Forty juvenile sheep (253 ± 6 days of age) were divided into four groups: Control (saline), T0 (0.6 mg/kg CLO on day 0), T84 (0.6 mg/kg CLO on day 84), and T0+84 (0.6 mg/kg CLO on days 0 and 84). Sheep were exercised 4 days/week and underwent physical and lameness examinations every 14 days. Blood samples were collected for SBB every 28 days. Microstructure and BMD were calculated from tuber coxae (TC) biopsies (days 84 and 165) and bone healing was assessed by examining the prior biopsy site. BT and GAG were evaluated postmortem. Data, except lameness data, were analyzed using a mixed-effects model; lameness data were analyzed as ordinal data using a cumulative logistic model. CLO did not have any measurable effects on the skeleton of sheep. SBB showed changes over time (p ≤ 0.03), with increases in bone formation and decreases in some bone resorption markers. TC biopsies showed increasing bone volume fraction, trabecular spacing and thickness, and reduced trabecular number on day 165 versus day 84 (p ≤ 0.04). These changes may be attributed to exercise or growth. The absence of a treatment effect may be explained by the lower CLO dose used in large animals compared to humans. Further research is needed to examine whether low doses of bisphosphonates may be used in active juvenile populations for analgesia without evidence of bone changes.
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Affiliation(s)
- Fernando B. Vergara-Hernandez
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
- School of Veterinary Medicine, College of Natural Resources and Veterinary Medicine, Universidad Santo Tomas, Viña del Mar, Chile
| | - Brian D. Nielsen
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
| | - John M. Popovich
- Center for Neuromusculoskeletal Clinical Research, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Char L. Panek
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Alyssa A. Logan
- School of Agriculture, College of Basic and Applied Sciences, Middle Tennessee State University, Murfreesboro, Tennessee, United States of America
| | - Cara I. Robison
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
| | - Richard A. Ehrhardt
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Tyler N. Johnson
- Department of Chemical Engineering and Materials Science, College of Engineering, Michigan State University, East Lansing, Michigan, United States of America
| | - Nicholas J. Chargo
- Department of Physiology, College of Natural Science, Michigan State University, East Lansing, Michigan, United States of America
| | - Thomas H. Welsh
- Department of Animal Science, College of Agriculture & Life Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Amanda N. Bradbery
- Department of Animal and Range Sciences, College of Agriculture, Montana State University, Bozeman, Montana, United States of America
| | - Jessica L. Leatherwood
- Department of Animal Science, College of Agriculture and Natural Resources, Tarleton State University, Stephenville, Texas, United States of America
| | - Aimee C. Colbath
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
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Yu Y, An D, Yang W, Verhamme P, Allegaert K, Nawrot TS, Staessen JA. Blood pressure and renal function responses in workers exposed to lead for up to six years. J Clin Hypertens (Greenwich) 2023; 25:1086-1095. [PMID: 37938055 PMCID: PMC10710557 DOI: 10.1111/jch.14748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/10/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Abstract
The Study for Promotion of Health in Recycling Lead (SPHERL) assessed the blood pressure (BP) and renal function (RF) responses for up to 6 years in the workers without previous occupational lead exposure. BP was the average of five consecutive readings and the estimated glomerular filtration rate was derived from serum creatinine (eGFRcrt) and cystatin C (eGFRcys). Blood lead (BL) was measured by inductively coupled plasma mass spectrometry (detection limit 0.5 μg/dL). The statistical methods included multivariable-adjusted mixed models and interval-censored Cox regression analysis. The 234 workers analyzed were on average 28.5 years old and included 91.9% men. The baseline BL concentration was 4.35 μg/dL and increased 3.17-fold over follow-up (median: 2.03 years; range: 0.92-6.45 years). The changes in BP and RF were not significantly correlated with the follow-up-to-baseline BL ratio (p ≥ .51 and p ≥ .18, respectively). The fully-adjusted changes in systolic/diastolic BP associated with a doubling of BL were -0.25/-0.12 mm Hg (CI: -0.94 to 0.44/-0.66 to 0.42 mm Hg). Accordingly, the incidence of stage-1 or -2 hypertension was not associated with the BL change (p ≥ .063). Similarly, the changes in eGFRcrt and eGFRcys associated with a 3-fold BL increment were not significant, amounting to -0.70 mL/min/1.73 m2 (CI: -1.70 to 0.30 mL/min/1.73 m2 ) and -1.06 mL/min/1.73 m2 (-2.16 to 0.03 mL/min/1.73 m2 ). In conclusion, the BP and RF responses to an over 3-fold BL increment were small and not significant confirming the safety of modern lead-handing facilities operating under current safety rules.
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Affiliation(s)
- Yu‐Ling Yu
- Research Unit Environment and HealthKU Leuven Department of Public Health and Primary CareUniversity of LeuvenLeuvenBelgium
- Non‐Profit Research Association Alliance for the Promotion of Preventive MedicineMechelenBelgium
| | - De‐Wei An
- Research Unit Environment and HealthKU Leuven Department of Public Health and Primary CareUniversity of LeuvenLeuvenBelgium
- Non‐Profit Research Association Alliance for the Promotion of Preventive MedicineMechelenBelgium
- Department of Cardiovascular MedicineShanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical GenomicsNational Research Centre for Translational MedicineRuijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Wen‐Yi Yang
- Department of CardiologyShanghai General Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Peter Verhamme
- Center for Molecular and Vascular BiologyKU Leuven Department of Cardiovascular Sciences, University of LeuvenLeuvenBelgium
| | - Karel Allegaert
- Department of Pharmaceutical and Pharmacological SciencesKU LeuvenLeuvenBelgium
- KU Leuven Department of Development and RegenerationKU LeuvenLeuvenBelgium
- Department of Hospital PharmacyErasmus Medical CenterRotterdamThe Netherlands
| | - Tim S. Nawrot
- Research Unit Environment and HealthKU Leuven Department of Public Health and Primary CareUniversity of LeuvenLeuvenBelgium
- Center for Environmental SciencesHasselt UniversityDiepenbeekBelgium
| | - Jan A. Staessen
- Non‐Profit Research Association Alliance for the Promotion of Preventive MedicineMechelenBelgium
- Biomedical Science GroupFaculty of MedicineUniversity of LeuvenLeuvenBelgium
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Kawakami S, Yasuno T, Kotoku K, Kawakami S, Ito A, Fujimi K, Matsuda T, Nakashima S, Masutani K, Uehara Y, Higaki Y, Michishita R. The differences in renal hemodynamic response following high-intensity exercise between younger and older males. Clin Exp Nephrol 2023; 27:972-980. [PMID: 37450106 DOI: 10.1007/s10157-023-02381-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Renal blood flow (RBF) decreases with exercise, but this change is only temporary, and habitual exercise may be an effective method to improve renal function. The kidney shows structural and functional changes with aging, but it is unclear how aging affects the hemodynamic response of the kidneys to exercise. Therefore, we evaluated the differences in the hemodynamic response of the kidneys to high-intensity exercise between younger and older men. METHODS Sixteen men (8 young and 8 older) underwent an incremental exercise test using a cycle ergometer with a 1-min warm up followed by exercise at 10-20 W/min until the discontinuation criteria were met. Renal hemodynamics were assessed before exercise, immediately after exercise, and at 60-min after exercise using ultrasound echo. RESULTS High-intensity exercise significantly reduced RBF in both groups (younger: ∆ - 53 ± 16%, p = 0.0005; older: ∆ - 53 ± 19%, p = 0.0004). In the younger group, RBF returned to the pre-exercise level 60-min after exercise (∆ - 0.4 ± 5.7%, p > 0.9999). In contrast, RBF 60-min after exercise was significantly lower than that before exercise in the older group (∆ - 24 ± 19%, p = 0.0006). The older group had significantly lower RBF than younger adults 60-min after exercise (423 ± 32 vs. 301 ± 98 mL/min, p = 0.0283). CONCLUSIONS Our findings demonstrate that RBF following high-intensity exercise recovered 60-min after exercise in younger group, whereas RBF recovery was delayed in the older group.
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Affiliation(s)
- Shotaro Kawakami
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Tetsuhiko Yasuno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Kazuko Kotoku
- Faculty of Fukuoka Medical Technology, Teikyo University, 6-22, Misaki-Machi, Omuta-Shi, Fukuoka, Japan
| | - Saki Kawakami
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Ai Ito
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Kanta Fujimi
- Department of Rehabilitation, Fukuoka University Hospital, Fukuoka, Japan
| | - Takuro Matsuda
- Department of Rehabilitation, Fukuoka University Hospital, Fukuoka, Japan
| | - Shihoko Nakashima
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Kosuke Masutani
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yoshinari Uehara
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Yasuki Higaki
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Ryoma Michishita
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan.
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan.
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Mukai Y, Kawasaki T, Kamijo YI, Furusawa K, Ibusuki T, Sakurai Y, Nishimura Y, Umemoto Y, Tajima F. Renal and Endocrine Responses to Arm Exercise in Persons with Cervical Spinal Cord Injury. J Clin Med 2023; 12:jcm12041670. [PMID: 36836205 PMCID: PMC9968162 DOI: 10.3390/jcm12041670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
The aim of this study was to assess renal functions and endocrine responses to arm exercise in persons with cervical spinal cord injury (CSCI) under euhydrated conditions (free drinking of water), and to determine the physiological effects of exercise on renal function in these subjects. Eleven CSCI individuals (spinal lesions between C6 and C8, American Spinal Injury Association impairment scale A) and nine able-bodied (AB) persons rested for 30 min before performing 30 min arm-crank ergometer exercises at 50% of their maximum oxygen consumption, followed by 60-min of rest/recovery. Urine and blood samples were collected before and immediately after the exercise and recovery period. The CSCI patients showed no increase in plasma adrenaline and plasma renin activity compared with the AB controls, but showed similar changes in plasma aldosterone and the plasma antidiuretic hormone in response to the exercise. Creatinine clearance, osmolal clearance, free water clearance, and the fractional excretion of Na+ did not change during exercise in both groups of subjects, however free water clearance in the CSCI group was higher than in the AB group throughout the study. These findings suggested that activated plasma aldosterone without an increase in adrenaline or renin activity during exercise in CSCI individuals may reflect an adaptation to the disturbance of the sympathetic nervous system to compensate for renal function. As a result, no adverse effects of exercise on renal function in CSCI patients were observed.
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Affiliation(s)
- Yuki Mukai
- Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Takashi Kawasaki
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectual University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshi-Ichiro Kamijo
- Department of Rehabilitation Medicine, Dokkyo Medical University Saitama Medical Center, Saitama 343-8555, Japan
| | - Kazunari Furusawa
- Department of Rehabilitation Medicine, Kibikogen Rehabilitation Center for Employment Injuries, Kibichuo-cho, Okayama 716-1241, Japan
| | - Tatsuru Ibusuki
- Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yuta Sakurai
- Research Center of Sports Medicine and Balneology, Nachikatsuura Balneologic Town Hospital, Tenma-Nachikatuura-cho, Wakayama 649-5331, Japan
| | - Yukihide Nishimura
- Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yasunori Umemoto
- Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, School of Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
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Two-year responses of renal function to first occupational lead exposure. Kidney Int Rep 2022; 7:1198-1209. [PMID: 35685322 PMCID: PMC9171623 DOI: 10.1016/j.ekir.2022.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/03/2022] [Accepted: 03/14/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Whether in advanced countries lead exposure still contributes to renal impairment is debated, because blood lead (BL) level is declining toward preindustrial levels and because longitudinal studies correlating renal function and BL changes over time are scarce. Methods The Study for Promotion of Health in Recycling Lead (SPHERL) evaluated the 2-year renal function responses in 251 workers (mean age, 29.7 years) transiting from environmental to occupational exposure. Main study end point was the estimated glomerular filtration rate (eGFR) derived from serum creatinine (eGFRcrt), cystatin C (eGFRcys), or both (eGFRcc). BL level was measured by inductively coupled plasma mass spectrometry (detection limit 0.5 μg/dl). Results In the follow-up, mean baseline BL level of 4.13 μg/dl increased 3.30-fold. In fully adjusted mixed models, additionally accounting for the within-participant clustering of the 1- and 2-year follow-up data, a 3-fold BL level increment was not significantly correlated with changes in eGFR with estimates amounting to −0.86 (95% CI: −2.39 to 0.67), −1.58 (−3.34 to 0.18), and −1.32 (−2.66 to 0.03) ml/min per 1.73 m2 for eGFRcrt, eGFRcys, or eGFRcc, respectively. Baseline BL level and the cumulative lead burden did not materially modify these estimates, but baseline eGFR was a major determinant of eGFR changes showing regression to the mean during follow-up. Responses of serum osmolarity, urinary gravity, or the urinary albumin-to-creatinine ratio (ACR) were also unrelated to the BL level increment. The age-related decreases in eGFRcrt, eGFRcys, and eGFRcc were −1.41, −0.96, and −1.10 ml/min per 1.73 m2, respectively. Conclusion In the current study, the 2-year changes in renal function were unrelated to the increase in BL level. However, given the CIs around the point estimates of the changes in eGFRcc and eGFRcys, a larger study with longer follow-up is being planned.
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Feng YM, Thijs L, Zhang ZY, Bijnens EM, Yang WY, Wei FF, Janssen BG, Nawrot TS, Staessen JA. Glomerular function in relation to fine airborne particulate matter in a representative population sample. Sci Rep 2021; 11:14646. [PMID: 34282189 PMCID: PMC8290004 DOI: 10.1038/s41598-021-94136-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/30/2021] [Indexed: 11/11/2022] Open
Abstract
From 1990 until 2017, global air-pollution related mortality increased by 40%. Few studies addressed the renal responses to ultrafine particulate [≤ 2.5 µm (PM2.5)], including black carbon (BC), which penetrate into the blood stream. In a Flemish population study, glomerular filtration estimated from serum creatinine (eGFR) and the urinary albumin-to-creatinine ratio were measured in 2005–2009 in 820 participants (women, 50.7%; age, 51.1 years) with follow-up of 523 after 4.7 years (median). Serum creatinine, eGFR, chronic kidney disease (eGFR < 60 mL/min/1.73 m2) and microalbuminuria (> 3.5/> 2.5 mg per mmol creatinine in women/men) were correlated in individual participants via their residential address with PM2.5 [median 13.1 (range 0.3–2.9) μg/m3] and BC [1.1 (0.3–18) μg/m3], using mixed models accounting for address clusters. Cross-sectional and longitudinally, no renal outcome was associated with PM2.5 or BC in models adjusted for sex and baseline or time varying covariables, including age, blood pressure, heart rate, body mass index, plasma glucose, the total-to-HDL serum cholesterol ratio, alcohol intake, smoking, physical activity, socioeconomic class, and antihypertensive treatment. The subject-level geocorrelations of eGFR change with to BC and PM2.5 were 0.13 and 0.02, respectively (P ≥ 0.68). In conclusion, in a population with moderate exposure, renal function was unrelated to ultrafine particulate.
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Affiliation(s)
- Ying-Mei Feng
- Department of Science and Technology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China. .,Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
| | - Lutgarde Thijs
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Zhen-Yu Zhang
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Esmée M Bijnens
- Center for Environment Sciences, Hasselt University, Diepenbeek, Belgium
| | - Wen-Yi Yang
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,Shanghai General Hospital, Shanghai, China
| | - Fang-Fei Wei
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China
| | - Bram G Janssen
- Center for Environment Sciences, Hasselt University, Diepenbeek, Belgium
| | - Tim S Nawrot
- Center for Environment Sciences, Hasselt University, Diepenbeek, Belgium
| | - Jan A Staessen
- Non-Profit Research Institute Alliance for the Promotion of Preventive Medicine, Mechlin, Belgium. .,Biomedical Sciences Group, Faculty of Medicine, University of Leuven, Leuven, Belgium.
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Liang J, Lan J, Tang Q, Ling W, Li M. Short- and long-term treatment with angiotensin-converting enzyme inhibitors or calcium channel blockers for the prevention of diabetic nephropathy progression: A meta-analysis. Exp Ther Med 2020; 21:14. [PMID: 33235623 PMCID: PMC7678606 DOI: 10.3892/etm.2020.9446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/14/2020] [Indexed: 11/05/2022] Open
Abstract
Treatments with angiotensin-converting enzyme (ACE) inhibitors or calcium channel blockers (CCBs) may delay the development of albuminuria in patients with early diabetic nephropathy. However, evidence in the literature has not been consistent. The present meta-analysis aimed to compare the short- and long-term therapeutic effects of ACE inhibitors and CCBs (when used separately) for preventing the progression of nephropathy in patients with diabetes mellitus. A comprehensive search of various databases was performed from inception until March 2015 for studies in the Chinese and English languages. Randomized controlled trials (RCTs) comparing the efficacy of ACE inhibitors with that of CCBs in patients with early diabetic nephropathy were considered. A total of 12 RCTs were included with a total of 947 patients. ACE inhibitors were indicated to be more effective in reducing the albumin excretion rate than CCBs after short-term treatments (<6 months) [mean difference (MD), 32.35; 95% confidence interval (CI), 31.62-33.07; P<0.00001]. There was no difference in serum creatinine values after treatment with either drug (MD, 8.7; 95% CI, -21.5-38.91; P=0.57). Data from six studies were used to compare long-term treatment effects (≥1 year). In terms of progression to normoalbuminuria, a marginal difference was obtained between the two drugs with better outcomes with ACE inhibitors [odds ratio (OR), 0.70; 95% CI, 0.49-1.00; P=0.05]. There was no statistically significant difference between ACE inhibitors and CCBs regarding the progression from microalbuminuria to macroalbuminuria (OR, 1.78; 95% CI, 0.82-3.87; P=0.15). In conclusion, the present study indicated that the antiproteinuric efficacy of CCBs may be less than that of ACE inhibitors after short-term treatment in patients with DN. However, both types of drugs are equally effective in reducing the progression of microalbuminuria to macroalbuminuria in the long term.
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Affiliation(s)
- Jialang Liang
- Endocrinology Department, Integrated Traditional Chinese and Western Medicine Hospital of Guangdong Province, Foshan, Guangdong 528200, P.R. China
| | - Jiarong Lan
- Nephrology Department, Huzhou Hospital of Traditional Chinese Medicine Affiliated Zhejiang University of Traditional Chinese Medicine, Huzhou, Zhejiang 313000, P.R. China
| | - Qizhi Tang
- Endocrinology Department, Integrated Traditional Chinese and Western Medicine Hospital of Guangdong Province, Foshan, Guangdong 528200, P.R. China
| | - Wenjing Ling
- Emergency Department, Integrated Traditional Chinese and Western Medicine Hospital of Guangdong Province, Foshan, Guangdong 528200, P.R. China
| | - Min Li
- Endocrinology Department, Huzhou Hospital of Traditional Chinese Medicine Affiliated Zhejiang University of Traditional Chinese Medicine, Huzhou, Zhejiang 313000, P.R. China
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Kuru O, Basralı F, Koçer G, Şentürk Ü. Nitric oxide involvement in post-exercise proteinuria of sedentary young men. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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9
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Sepehrian A, Shakeri N, Abednatanzi H, Soheili S. The Effect of Methylphenidate and Aerobic Exercise on Renal Function of Male Rats. INTERNATIONAL JOURNAL OF BASIC SCIENCE IN MEDICINE 2019. [DOI: 10.15171/ijbsm.2019.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Inadequate awareness and knowledge exists regarding the effects of stimulant drugs on renal health among athletes. The present study aimed to determine the effects of methylphenidate, as a stimulant drug, and aerobic exercise on renal function in rats. Materials and Methods: Eighty male rats were randomly divided into 8 groups (n=10 per group) including control (Co), aerobic exercise sham (AE Sh), drug sham (D Sh), aerobic exercise (AE), the effective dose of drug (ED, 10 mg/kg), 3 times of effective dose (TED, 30 mg/kg), aerobic exercise-effective dose (AE-ED), and aerobic exercise-three times of effective dose (AE-TED). The drug was orally administrated to the animals, and then they were placed on a rat treadmill after 30 minutes. The physical activity (25 m/min) was performed 30 minutes a day, 3 days a week for two months. Twenty-four hours after the last session of AE, blood samples were taken from the rats and serum creatinine (Cr) and blood urea nitrogen (BUN) were determined. Results: The results showed that serum Cr and BUN levels were not significantly different in the exercise group compared to the control groups (i.e., Co, AE Sham, and D Sham). However, serum BUN and Cr significantly increased in the AE-ED and AE-TED groups compared to the AE group (PCr=0.001 and PBUN=0.001). Conclusion: In general, significant increases in the serum BUN and Cr levels in rats received methylphenidate indicated decreased renal function in these animals.
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Affiliation(s)
- Ali Sepehrian
- Ph.D. Student of Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nader Shakeri
- Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hosein Abednatanzi
- Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Shahram Soheili
- Department of Physical Education and Sport Sciences, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
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10
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Filler G, Lee M. Educational review: measurement of GFR in special populations. Pediatr Nephrol 2018; 33:2037-2046. [PMID: 29218435 DOI: 10.1007/s00467-017-3852-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/13/2017] [Accepted: 11/16/2017] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Changes in kidney function are typically followed by the sequential estimation of glomerular filtration rate (eGFR). Formulae for eGFR work well on a population basis, but there are well-known conditions where they do not work. OBJECTIVE The purpose of this review is to summarize the existing literature on special populations in the pediatric age range and provide recommendations on how to estimate GFR in these populations. FINDINGS The reliability of creatinine depends on muscle mass, while cystatin C (not widely available) is limited by inflammation and changes in protein catabolism. Various dietary factors can alter eGFR. Renal function in neonates changes drastically every day, and there are currently no satisfactory reference intervals for routine pediatric use. Gender effects and conditions such as wasting disease and obesity require alternative ways to obtain eGFR. In oncology patients, chemotherapy may negatively affect renal function, and nuclear GFR measurements may be necessary. For body builders, high muscle mass may lead to underestimation of eGFR using creatinine. CONCLUSIONS AND RELEVANCE Clinicians should be aware of special populations that may yield misleading eGFRs with conventional creatinine-based formulae, and that the alternative methods may be more appropriate for some populations.
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Affiliation(s)
- Guido Filler
- Department of Pediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N6A 5W9, Canada. .,Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N6A 5W9, Canada. .,Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N5A 5A5, Canada. .,Children's Hospital, London Health Science Centre, University of Western Ontario, 800 Commissioners Road East, London, ON, N6A 5W9, Canada.
| | - Misan Lee
- Department of Pediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N6A 5W9, Canada
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11
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Suzuki M. Physical exercise and renal function. JOURNAL OF PHYSICAL FITNESS AND SPORTS MEDICINE 2015. [DOI: 10.7600/jpfsm.4.17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Braun L, Sood V, Hogue S, Lieberman B, Copley-Merriman C. High burden and unmet patient needs in chronic kidney disease. Int J Nephrol Renovasc Dis 2012; 5:151-63. [PMID: 23293534 PMCID: PMC3534533 DOI: 10.2147/ijnrd.s37766] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Chronic kidney disease (CKD) is a complex debilitating condition affecting more than 70 million people worldwide. With the increased prevalence in risk factors such as diabetes, hypertension, and cardiovascular disease in an aging population, CKD prevalence is also expected to increase. Increased awareness and understanding of the overall CKD burden by health care teams (patients, clinicians, and payers) is warranted so that overall care and treatment management may improve. This review of the burden of CKD summarizes available evidence of the clinical, humanistic, and economic burden of CKD and the current unmet need for new treatments and serves as a resource on the overall burden. Across countries, CKD prevalence varies considerably and is dependent upon patient characteristics. The prevalence of risk factors including diabetes, hypertension, cardiovascular disease, and congestive heart failure is noticeably higher in patients with lower estimated glomerular filtration rates (eGFRs) and results in highly complex CKD patient populations. As CKD severity worsens, there is a subsequent decline in patient health-related quality of life and an increased use of health care resources as well as burgeoning costs. With current treatment, nearly half of patients progress to unfavorable renal and cardiovascular outcomes. Although curative treatment that will arrest kidney deterioration is desired, innovative agents under investigation for CKD to slow kidney deterioration, such as atrasentan, bardoxolone methyl, and spherical carbon adsorbent, may offer patients healthier and more productive lives.
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Affiliation(s)
| | - Vipan Sood
- Mitsubishi Tanabe Pharma America, Inc, Warren, NJ, USA
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13
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Poortmans JR, Gulbis B, De Bruyn E, Baudry S, Carpentier A. Limitations of serum values to estimate glomerular filtration rate during exercise. Br J Sports Med 2012; 47:1166-70. [DOI: 10.1136/bjsports-2012-090976] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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14
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Kuritzky L, Toto R, Van Buren P. Identification and Management of Albuminuria in the Primary Care Setting. J Clin Hypertens (Greenwich) 2011; 13:438-49. [DOI: 10.1111/j.1751-7176.2010.00424.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Effects of high-whey-protein intake and resistance training on renal, bone and metabolic parameters in rats. Br J Nutr 2010; 105:836-45. [DOI: 10.1017/s0007114510004393] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Consumption of high-protein (HP) diets is postulated to exert a negative influence on bone and renal health. However, no conclusive evidence has been presented related to this issue or to the potential protective action of resistance training on HP-induced systemic effects. We examined the effects of HP diet consumption on food intake, body-weight gain, body composition, and renal, bone and metabolic parameters of rats performing resistance training. A total of ninety-six adult male Wistar rats were randomly distributed in twelve experimental groups (n 8): normal-protein (10 %) or HP (45 %) diets, with or without resistance training, killed for experimental periods of 1, 2 or 3 months. Diets were based on a commercial whey protein hydrolysate. Consumption of HP diets and resistance training significantly affected food intake, body weight and body composition, as well as the plasma levels of total cholesterol, HDL-cholesterol and TAG. The buffering action of resistance training on such diet-induced alterations was especially evident in the levels of plasma TAG. Consumption of HP diets led to a considerable increase in kidney weight, urinary volume and acidity, as well as in the urinary excretion of Ca, with a parallel reduction in the urinary excretion of citrate (P < 0·05). No apparent deleterious effect on bone mineral content was found. In conclusion, consumption of HP diets caused alterations in renal health status and some metabolic parameters, but did not seem to affect bone status. Resistance training had a protective action against alterations of renal health status and some metabolic parameters such as plasma TAG.
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Gouthon P, Tonon B, Ouendo E, Falola J, Agboton B, Dansou H, Poortmans J. Évolution des paramètres associés à la fonction rénale après un match de basketball en milieu africain subsaharien. Sci Sports 2009. [DOI: 10.1016/j.scispo.2009.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Saraslanidis PJ, Manetzis CG, Tsalis GA, Zafeiridis AS, Mougios VG, Kellis SE. Biochemical Evaluation of Running Workouts Used in Training for the 400-m Sprint. J Strength Cond Res 2009; 23:2266-71. [DOI: 10.1519/jsc.0b013e3181b8d2d3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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18
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Lowery LM, Devia L. Dietary protein safety and resistance exercise: what do we really know? J Int Soc Sports Nutr 2009; 6:3. [PMID: 19138405 PMCID: PMC2631482 DOI: 10.1186/1550-2783-6-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Accepted: 01/12/2009] [Indexed: 11/30/2022] Open
Abstract
Resistance trainers continue to receive mixed messages about the safety of purposely seeking ample dietary protein in their quest for stimulating protein synthesis, improving performance, or maintaining health. Despite protein's lay popularity and the routinely high intakes exhibited by strength athletes, liberal and purposeful protein consumption is often maligned by "experts". University textbooks, instructors, and various forms of literature from personal training groups and athletic organizations continue to use dissuasive language surrounding dietary protein. Due to the widely known health benefits of dietary protein and a growing body of evidence on its safety profile, this is unfortunate. In response, researchers have critiqued unfounded educational messages. As a recent summarizing example, the International Society of Sports Nutrition (ISSN) Position Stand: Protein and Exercise reviewed general literature on renal and bone health. The concluding remark that "Concerns that protein intake within this range [1.4 – 2.0 g/kg body weight per day] is unhealthy are unfounded in healthy, exercising individuals." was based largely upon data from non-athletes due to "a lack of scientific evidence". Future studies were deemed necessary. This assessment is not unique in the scientific literature. Investigators continue to cite controversy, debate, and the lack of direct evidence that allows it. This review discusses the few existing safety studies done specific to athletes and calls for protein research specific to resistance trainers. Population-specific, long term data will be necessary for effective education in dietetics textbooks and from sports governing bodies.
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Affiliation(s)
- Lonnie M Lowery
- Nutrition Assessment Laboratory, Nutrition Center, 210 Schrank Hall South, University of Akron, Akron, Ohio, 44325-6103, USA.
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Miller WG, Bruns DE, Hortin GL, Sandberg S, Aakre KM, McQueen MJ, Itoh Y, Lieske JC, Seccombe DW, Jones G, Bunk DM, Curhan GC, Narva AS. Current issues in measurement and reporting of urinary albumin excretion. Clin Chem 2008; 55:24-38. [PMID: 19028824 DOI: 10.1373/clinchem.2008.106567] [Citation(s) in RCA: 233] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Urinary excretion of albumin indicates kidney damage and is recognized as a risk factor for progression of kidney disease and cardiovascular disease. The role of urinary albumin measurements has focused attention on the clinical need for accurate and clearly reported results. The National Kidney Disease Education Program and the IFCC convened a conference to assess the current state of preanalytical, analytical, and postanalytical issues affecting urine albumin measurements and to identify areas needing improvement. CONTENT The chemistry of albumin in urine is incompletely understood. Current guidelines recommend the use of the albumin/creatinine ratio (ACR) as a surrogate for the error-prone collection of timed urine samples. Although ACR results are affected by patient preparation and time of day of sample collection, neither is standardized. Considerable intermethod differences have been reported for both albumin and creatinine measurement, but trueness is unknown because there are no reference measurement procedures for albumin and no reference materials for either analyte in urine. The recommended reference intervals for the ACR do not take into account the large intergroup differences in creatinine excretion (e.g., related to differences in age, sex, and ethnicity) nor the continuous increase in risk related to albumin excretion. DISCUSSION Clinical needs have been identified for standardization of (a) urine collection methods, (b) urine albumin and creatinine measurements based on a complete reference system, (c) reporting of test results, and (d) reference intervals for the ACR.
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Affiliation(s)
- W Greg Miller
- Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA.
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Berkemeyer S, Vormann J, Günther ALB, Rylander R, Frassetto LA, Remer T. Renal net acid excretion capacity is comparable in prepubescence, adolescence, and young adulthood but falls with aging. J Am Geriatr Soc 2008; 56:1442-8. [PMID: 18808599 DOI: 10.1111/j.1532-5415.2008.01799.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To evaluate whether renal net acid excretion capacity (NAEC) varies across different age groups and, specifically, whether it falls in elderly people. DESIGN Cross-sectional observational study. SETTING Community-based. PARTICIPANTS Young participants were from the DOrtmund Nutritional and Anthropometric Longitudinally Designed Study, Dortmund, Germany; elderly participants were from Gothenburg, Sweden. MEASUREMENTS Twenty-four-hour urine pH, net acid excretion (NAE), urinary phosphorus, total nitrogen excretion, and anthropometric data were measured in healthy elderly people (aged 55-75; n=85), young adults (aged 18-22; n=117), adolescents (aged 13-14; n=112), and prepubescent children (aged 6-7; n=217). NAEC was determined as 24-hour NAE adjusted for urine pH using the residual method. RESULTS In elderly participants 24-hour urinary pH (5.9+/-0.53) was lower (P<.05) and NAE (60+/-27 mEq/d) higher (P<.05) than in the three other groups. In a regression model adjusted for age, sex, and body surface area, NAEC showed a clear decrease with age, with highest values in prepubescents and lowest in elderly participants. However, NAEC remained significantly lower only in elderly participants (P<.001) after the inclusion of total nitrogen excretion, a protein intake index, which was included because protein intake is known to modulate renal function. NAEC was approximately 8 mEq/d lower in healthy elderly participants than in young adults. CONCLUSION The capacity to excrete net endogenous acid does not vary markedly from childhood to young adulthood but falls significantly with age, implying that elderly people may require higher daily alkalizing mineral intake to compensate for renal function losses.
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